face was pale, covered with copper-red spots of various sizes and forms, which were also found on parts of the trunk and extremities. These spots varied in color, were darkest on the abdomen, and on the anterior portion of the left thigh, where they were as large as the palm of the hand. Tongue dry, covered with a brownish coat. The mucous membrane of the mouth and fauces swollen and injected. Pressure on the stomach painful. The bladder was distended above the navel. For two days the patient passed urine only with great effort, and very seldom. There was a short dry cough. Respiration 26; on deep inspiration stitches in the lower portion of the right half of the chest. Dulness in the lower portion of the right side of the chest; respiratory murmur impaired, with fine râles; through the other portions of the lungs were coarse râles with increased respiratory murmur. Urine evacuated with the catheter reddish brown. The bladder continued paralyzed; the patient developed pneumonia with infiltration of the right middle and lower portions of the lungs, inflammation of the pharynx and stomach, the vasomotors paralyzed; general loss of power and emaciation; inflammation of the skin; places formed blisters and ulcers, bed-sores; gradual recovery,2-A boy was found dead, a girl, man, and woman were still living. In all the bodies were cold, the limbs were relaxed, pulse imperceptible, pupils dilated, mouth spasmodically closed, respiration irregular and superficial. The blood was very darkcolored. On the second day, the skin and mucous membrane of the woman became gangrenous, the urine dark brown, after which she died, 43.—On waking (waked by wife at 5.30 A.M.), a general vague distress, and on getting up was giddy; tendency to fall to the side obliged him to sit down for security. Then distress in præcordium, a kind of anguish, with sighing respiration, . and slight nausea, caused by this præcordial distress; then a free fecal evacuation, painless, like a relaxation of bowels which follows fear or excitement (soldiers going into action), with a decided urging; rapid action of heart on exertion; pulsations very audible in left ear. Short cough when moving; præcordial distress; had to sit while dressing; sensitive to outer air; circulation very much depressed, and did not regain its tone for a long time. No inclination to urinate like the urgency to stool. Headache came on after moving around; is a throbbing headache, a headache similar to his usual exhausted headaches. No appetite, could not eat his usual hearty breakfast. Mouth thick and pasty; no bad taste; saliva is thick. Hands moist, inclined to be cool,5.-Has distress across thorax. The distress in præcordium so great that she became moist; skin hot (also sensitive to cold air as usual), with nausea. Free evacuation of bowels, no appetite. Weak, could not get up. This distress seemed so bad, before she arose, as though she was dying. It stopped menstruation, then three days advanced (usually runs six or seven days). The looseness of the bowels continued and gradually produced tenesmus, six passages in twentyfour hours. Coffee gave decided temporary relief for three hours,56.Head, face, and neck livid, and greatly bloated, so as to destroy all recognizable features; the lower lip immensely swollen and turned outwards; the skin discolored and cold, without moisture; extremities quite cold; pulse varying in force and frequency, at times almost imperceptible, the number ranging at different times from 80 to 120; breathing labored, blowing, and irregular; eyelids closed, balls rolled up aslant, pupils varying somewhat but generally dilated; entire insensibility to outward impres sions, even of the most painful character; no motion of any muscles except those concerned in respiration, which was chiefly diaphragmatic,.-[390.]

His appearance was that of a calm and tranquil sleep; countenance was of a pale leaden aspect; his lips and ears were livid; respiration inaudible at a short distance, extremely short and suffocative, with intervals of suspension; pulse rapid, small, and at times imperceptible; pupils contracted, but the retina was sensible to the impression of light; muscular system relaxed and powerless; he appeared like one whose functions and powers of the system were almost extinguished,.-Face suffused and purple; expression of agonized suffering; the temporal artery distended and prominent; respiration rapid and sonorous, resembling a groan more than snoring; pulse moderately full but frequent; the muscles seemed rigid and contracted; pupils dilated; vomiting,".-If a person be plunged entirely, with the exception of the head, into a bath of Carbonic acid gas at the ordinary temperature, there will be experienced a decided sensation of heat over the parts of the body in contact with the gas. This sensation of heat is pleasant, and may be compared with that produced by a fine soft garment or padding applied to the skin. If the bath be prolonged for a quarter of an hour, the sensation of heat becomes more intense, and accompanied by a peculiar prickling and tingling; in some persons whose skin is very sensitive it reddens, and there is experienced a burning heat. The whole surface of the body then transpires freely. The urinary secretion is decidedly increased. At last, after the gas has remained in contact with the skin for a longer time (some hours), the skin becomes numb, and anaesthesia takes place, so that pricking or pinching can be endured without sensation,.-Normal condition, pulse 68, saliva alkaline, urine clear, acid, temperature in the axilla 26° R. At 9.46, I entered the cabinet containing the gas, and in one minute afterwards experienced a pleasant sensation of heat over all parts of the body. 9.50, the heat had decidedly increased, was especially pronounced in the pit of the stomach and in the internal portions of the limbs, especially of the thighs, associated with an agreeable tingling in the genital organs. 9.54, the heat had increased and was very difficult to bear; only the feet were somewhat cold. 9.56, experienced along the superior dorsal region slight prickling. 10.1, pulse remained the same; the body was very red and covered with perspiration. Extreme heat was felt over all parts of the body, especially in the palms. Two other persons were in the lower part of the same cabinet; they experienced different degrees of oppression. In one the respiration was very much oppressed, with very great desire to lie down. 10.7, my two companions were obliged to open the window; though I was not so greatly inconvenienced, still the fresh air was very agreeable. 10.16, my pulse had fallen to 60, all my limbs were very supple; the general sensation of health was increased. At another time the pulse fell to 52, and there was some pain in the head. Another person in the bath described the sensation as of a band above the eyes, and a very severe frontal pain. The baths were frequently followed by violent itching over all parts of the body. After the bath the saliva was acid. The capillary circulation was much more active. The following were the effects of a bath taken in the evening, July 15th, pulse 76, respiration 19. I entered the bath at 5.10. At 5.13, the heat steadily increasing, the current of gas passing over the body causes an irresistible desire to sneeze. 5.15, burning heat between the shoulders. 5.18, respiration 16, pulse unchanged. 5.22, perspiration begins on the face. 5.25, sensation of burning heat very intense between the shoulders, and drops of sweat rolling down over my chest. 5.30, perspiration general. 5.40, pulse full, regular, 76; perspiration profuse. If

one plunges the head into a bath of Carbonic acid gas, there is immediately experienced heat, especially about the face and eyes. The gas getting into the nose causes prickling in the mucous membrane, sneezing, and profuse secretion of mucus,".-He experienced prickling in the eyes, vertigo, thundering in the ears, suffocation, the face became blue, purple, etc.,.-Profuse lachrymation, heat of the face, rush of blood to the head,". -He inhaled the gas mixed in various proportions with atmospheric air. From 1 to 13 there was very little effect. 1 to 10 caused prickling in the limbs, and a sensation of constriction of the chest. 1 to 4 caused asphyxia and an increase of the pulse from 73 to 137, but it immediately fell to 98 on removing the gas,--The secretions are in general increased, perspiration considerable, urinary secretion decidedly increased, and there were frequent efforts to urinate. Often the gas causes rush of blood to the hæmorrhoids, increased menstruation, epistaxis, and often hæmoptysis. In the organs of generation it causes great heat and excitement and turgescence. In women increased menstruation,".-Coma, red streaks running along the forearm in the course of the radial nerve, followed by swelling of the subcutaneous tissue, especially on the right side, and along the right supraorbital nerve. Subsequent development of herpes on the lips and on the forearm, and along the ischiatic nerve; development of bed-sore,.After the poisoning there developed zona on the left side of the face, corresponding to the course of the trigeminus nerve,"1.

CARBONEUM SULFURATUM.

Authorities. 24 to 47, A. Delpech, Nouv. Recherches sur L'Intoxication Spéciale que determine le Sulfure de Carbone l'Industrie du Caoutchouc Soufflé, Paris, 1863, twenty-four new cases among workers in rubber factories; 48, J. B. Tavera, Thèse de l'Intoxication par le Sulfure de Carbone, Paris, 1865, a woman worker in a rubber factory; 49, same, case of a man; 50 to 52, Gourdon, Thèse de l'Intoxication par le Sulfure de Carbone, Paris, 1867, effects on men; 53 to 55, Abel Marché, Thèse de l'Intoxication par le Sulfure de Carbone, Paris, 1876; (56 and 57, Berridge, Collection in Appendix in Brit. Journ. of Hom.); 56, Wutzer and Pellengham, Journ. de Chim. (Lancet, 1830-1 (2), 329), general effects; 57, Dr. Geo. Kennison, Med. Times and Gaz., 1868 (2), 77, effects of external application; 58, Dr. Davidson, ibid., 1878 (2), 350, W. G., æt.' thirty-three years, took a quantity.

Mind.- Delirium, with incoherent talking,.-On two occasions he had nervous attacks analogous to hysteria; the face was affected by convulsive movements, but he did not lose consciousness; laughed involuntarily and irrepressibly,".-At one time during the night he seemed to be surrounded by enemies; persons were coming to harm him; he heard imaginary voices and saw strange objects; this continued for four days, and he was taken to the hospital,.-Hallucinations of vision and hearing, he seemed to see splendid spectacles of carriages, with magnificent objects, talked of the emperor, of money, and of grandeur, often incoherently,. -Violent cerebral excitement, so that he had to be put into a straitjacket,It seems to him as if he were constantly in a state of intoxication,-Beat his wife,".-Violent and irascible,".-Incessant desire to prattle and laugh without cause,".- [760.] Excessive gayety, followed by sadness and moroseness,.-At first he was excessively gay, but with the

ness,

46

progress of the poisoning he became extremely sad, and lost all energy,38. -Exaggerated gayety, changing to profound sadness and absolute indifference,.-Screaming,.-Extreme loquacity,".-Excessive loquacity, but he cannot think of the words he wishes to use; he searches in vain for an expression, and an attempt to speak results in stammering,".-The patient was sad, preoccupied,32 --Preoccupation, with sad, melancholy ideas, indifferent to all about her,.-When interrogated he replied by monosyllables or by signs with the hands; his intellect was greatly impaired, he sought solitude, and like a child was occupied by the objects immediately about him; when not amused he was inactive, seemed distrait,".-Unable to fix the attention,29. — [770.] Oppression,". - Sad,. - Profound sad,25 31, etc.—Profound sadness, with irritable desire to weep,28.-His mood is completely changed; there is now profound sadness, with excessive impatience; at times absolute indifference gives place to the most violent. anger, when he manifests great energy,".-Wept with great facility," Irritable,26 37-Great irritability,-Excessive irritability, intolerance of contradiction, 42 55. -Became exceedingly irritable and violent," ".[780.] He became extremely irritable, violent, and intolerant of contradiction,". -His character changed entirely, at first he became irritable, afterward sombre and sad,".-Complete indifference,".-Memory profoundly impaired,27 29.-This man, usually intellectual, has now lost all desire for study; his imagination is wholly occupied with the most absurd reveries,".-Unable to find words to express his thoughts,".-Incoherence of ideas,”.— Loss of memory,25 26, etc.-Progressive loss of memory,25 41.-Weak memory, especially for recent events,".-[790.] Loss of memory, with difficulty in expressing ideas,".-His memory became defective, and he found it very difficult to formulate his ideas, or express them by words,.-Complete loss of memory, .-Stupid; cannot fix his thoughts upon any object, cannot express his thoughts,.-Loss of consciousness, lasting several minutes,.-On two occasions the patient fell suddenly with loss of consciousness,.-One day he fell down, lost consciousness, had an epileptic attack, followed by paralysis of the limbs,.-Complete loss of consciousness at one time,"

31 38

28 32

27

Head.-Vertigo,26 27, etc.-Intense vertigo," ".-[800.] Frequent intense vertigo,.-Attacks of vertigo, so that he could scarcely stand, with partial loss of consciousness,".-Sudden vertigo, during which he nearly fell to the ground, and had to be taken home,.-Intense vertigo, with loss of smell; vision was affected in that all objects seem larger than they really are,.-Violent vertigo, reeling so that he was obliged to stop at almost every step,".-Heaviness of the head,".-Headache, 29, etc.-Intense headache, etc.-Most intense headache, with a sensation of painful pressure in the temples (first day),".-Violent headache, with distressing throbbing at the temples, aggravated towards evening,".-[810.] Violent intense headache, characterized by compressing pain from one temple to the other, associated with vertigo and great agitation,.-Constrictive headache,.-Compressing headache,.-Headache like the painful pressure of a tight cap,".-Very intense compressible headache, especially in the root of the nose, and in the temples; it consisted of a sensation of most violent constriction in the temples, without throbbing; it was associated with extreme stiffness of the neck; this painful stiffaess, especially over the posterior portion of the neck, was. accompanied by a local sensation of very great coldness; the patient experienced great pain in turning the head; the pain in the neck was associated with very distressing ver

38

tigo, Sensation as if a band of iron were compressing the head,.Violent intermittent pain in the head and frontal region,.-Lancinating pain in the head,".-Intense frontal headache,25.-Violent frontal headache, especially in the evening, with vertigo and ringing in the ears,52.[820.] Temporal headache," "-Compressing headache through the temples,".-Violent compressive headache through the temples, aggravated by walking, so that each step caused a violent, painful shock in the head," Intense compressive headache, occupying the temples and occiput,*.—Violent pain in the right side of the head,.

Eye.-At one time was seized with violent inflammation of the right eye, kerato-iritis, treated by Calomel and Atropia,".--Eyes fixed, without expression; pupils dilated, especially the left, but very sluggish; the patient, however, could not see with the right eye as with the left; the ophthalmoscope showed in the former very slender retinal veins, extravasations of blood into the vitreous, extremely fine filaments and points floating in the vitreous,".-Ophthalmoscopic examination showed the papillæ very pale and deeply excavated, after several months,".-Progressive atrophy of the ophthalmic papillæ of the left eye,".-Pupils mobile, moderately dilated; the field of vision normal; ophthalmoscopic examination revealed a slight paleness of the internal segment of the optic nerve of both sides ; there was marked excavation of the papillæ, which were less transparent than normal; the optic nerve had the appearance of a smoked glass,". [830.] Pupils sluggish, rather dilated. Ophthalmoscopic examination of the fundus of the eye showed depigmentation and some dilatation of the retinal veins,".-Pupil incompletely dilated (he had lost his right eye by getting a drop of the vulcanizing mixture into it, followed by intense pain and ophthalmia, and formation of a staphyloma of the cornea and iris),". -Sensation of heat and pricking in the eyes,.-Marked anesthesia of the cornea, which was insensible to pricking with a pin,.-Marked anæsthesia of the cornea,".- Lids. Lids affected by spasmodic trembling,.Pupil. Pupils dilated,26 50 51-Vision. Vision at first very clear,". Great susceptibility to light,.-Dimness of vision,".-[840.] Mist before the eyes, 4950-Vision dim, as through a veil,".-Vision dim, as though objects were enveloped in a mist,".-Amblyopia; all objects seem covered with a mist,.-Reading was impossible, for though the left eye distinguished objects, the right seemed covered with a mist,".-Vision became dim. Permanent and progressive alteration of vision; pupils contracted, insensible, sensitive to Belladonna; the ophthalmoscope showed that the optic was congested,".-Vision became remarkably affected; there was diminished clearness of objects, which seemed enveloped in mist; on attempting to read the letters moved and trembled; the use of a glass was of no avail,".-Vision is distinct for a limited distance, but beyond that everything is enveloped in a mist,2"-Vision impaired, so that it was difficult to distinguish objects,.-Vision became disturbed; a portion of the field of vision was obscured, so that he no longer saw the concluding letters,".[850.] Vision feeble, was unable to read the names of the streets,".-Vision impaired; all objects seemed to tremble,.-Tremulous vision; all objects seen enveloped in mist,".-Difficulty in fixing the vision upon any object,.-Loss of vision of the right eye,".-Vision completely lost,".Double vision, 50.

43

32

29

Ear.-Very painful pricking in the external meatus auditorius,.Impaired hearing, 26 749-Hearing very much impaired; it seems as though something were stuffed into the ears,".-[860.] Hearing in the left ear